State abortion records full of gaps

Thousands of procedures not reported to health department

June 16, 2011|By Megan Twohey, Tribune reporter

Health care providers are failing to detail abortion complications to the state as required by law, one of many gaps in a surveillance system viewed as crucial to protecting patients, a Tribune review has found.

The state's system for tracking abortions is so broken that regulators also may be missing more than 7,000 of the procedures per year.

The Illinois Department of Public Health must collect details about every abortion performed in the state, including whether the patient is injured or dies.

The mandatory reporting is essential for tracking trends in public health and can provide a window into quality of care. While abortion has proven to be a very safe procedure, heightened rates of complications or clusters of deaths could signal problems with particular providers.

"If people are looking at reports and seeing excessive complications, that might warrant another look or another inspection," said Vicki Saporta, president of the National Abortion Federation, an association of providers.

But there are significant holes in state monitoring of a procedure that affects tens of thousands of Illinois women each year. Nationally, current rates suggest that nearly 1 in 3 women will have an abortion, according to research published in the medical journal Obstetrics & Gynecology.

The Tribune found:

•State regulators have documented between 7,000 and 17,000 fewer abortions a year than a national research group found in Illinois.

•This reporting is the only tool Illinois authorities have to monitor some abortion providers, yet regulators may be allowing doctors and clinics to operate off the books. Regulators collect reports from 26 providers, but the abortion rights research group has identified 37 providers doing business in the state.

•Also unknown to officials are the types of abortion-related problems experienced by women. Nearly 4,000 reports of abortion complications involving Illinois residents in 2009 were missing the required description.

•Health care providers who intentionally fail to submit accurate and complete reports are committing a criminal act, and a failure to report abortion complications is grounds for revoking their licenses, but the Department of Public Health has never sought disciplinary action against a provider.

Kelly Jakubek, an agency spokeswoman, said in a written response that it was the responsibility of abortion doctors to ensure they comply with the mandatory reporting requirement.

Regulators don't respond to the reports in any way, she said, because they view the information as serving statistical purposes only.

"It's outrageous," declared Maurice Stevenson, whose wife died in 2002 from infection following an abortion at a Planned Parenthood clinic in Chicago. "These procedures, complications and deaths should be public record."

Critics contend that accurate government accounting is essential, especially with a politically charged issue such as abortion in which both sides push information to further their agendas.

A review of malpractice cases revealed other abortion-related complications in Illinois — with no way of knowing whether they were reported to the state.

For example, in 2002, after an area woman's uterus was torn in an abortion she began hemorrhaging, went into cardiac shock and was hospitalized for three weeks. Several years later, a mother of three experienced seizure symptoms and slipped into a coma following her abortion at a city clinic. And in 2009, a teenage girl suffered respiratory and cardiac arrest and died immediately following her abortion in a northern suburb, according to court records.

The state Legislature included mandatory reporting in the 1975 Illinois Abortion Law, a compilation of guidelines enacted after the U.S. Supreme Court decision in Roe v. Wade.

Abortion providers succeeded in stripping away many of the law's other requirements, but a 1993 legal settlement between providers and the state retained mandatory reporting "to better protect the health of women undergoing these procedures."

Why does the information matter?

The confidential reports are "very important from both a demographic and public health viewpoint," according to the federal Centers for Disease Control and Prevention, which surveys abortion data collected by the states.

In addition to illuminating trends in unplanned pregnancies and documenting access to abortion, the reports have helped to reveal that certain procedures carry higher risks of complications and that dangers increase exponentially as the pregnancy progresses.

In Illinois, reporting also provides an opportunity to monitor all doctors who perform abortions. Not all abortion providers are licensed as such. The Department of Public Health has licensed 14 providers as ambulatory surgical treatment or pregnancy termination specialty centers.